Fetal cardiac output in monochorionic twins.
OBJECTIVE
To compare fetal cardiac output (CO) in donor and recipient twins of twin-twin transfusion syndrome (TTTS) pregnancies after laser therapy with that of monochorionic twins without TTTS and normal singletons.


METHODS
In a longitudinal, prospective study, we sonographically assessed fetal CO in donors (n = 10) and recipients (n = 10) with TTTS after fetoscopic laser therapy, in monochorionic twins without TTTS (n = 20) and in normal singleton pregnancies (n = 20). The fetal CO of TTTS twins was determined 1 day and 1 week after laser treatment, and from then on every 2-4 weeks until birth. Twins without TTTS were examined biweekly until birth. Singletons were examined twice, with an 8-week interval, at different gestational ages between 17 and 35 weeks.


RESULTS
Absolute CO increased exponentially with advancing gestational age (P < 0.0001), and was significantly related to fetal weight in all groups (P < 0.0001). The median CO/kg in donors after laser therapy, recipients after laser therapy and non-TTTS monochorionic twins was significantly higher than that in singletons (all P < 0.001). Median CO/kg in donors after laser therapy, recipients after laser therapy, and non-TTTS monochorionic twins was not significantly different between groups.


CONCLUSIONS
Monochorionic twins with TTTS have higher CO after laser therapy than normal singletons.
Sueters
M
M
Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Middeldorp
J M
JM
Lopriore
E
E
Bökenkamp
R
R
Oepkes
D
D
Teunissen
K A
KA
Kanhai
H H H
HH
Le Cessie
S
S
Vandenbussche
F P H A
FP
D001699:Biometry; D002302:Cardiac Output / Q000502:physiology*; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000601:surgery; D005865:Gestational Age; D006801:Humans; D053685:Laser Therapy; D008137:Longitudinal Studies; D010920:Placenta / Q000098:blood supply; D011247:Pregnancy; D011446:Prospective Studies; D013577:Syndrome; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology